US20210338353A1 - Surgical cannulas, and related systems and methods - Google Patents
Surgical cannulas, and related systems and methods Download PDFInfo
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- US20210338353A1 US20210338353A1 US17/325,825 US202117325825A US2021338353A1 US 20210338353 A1 US20210338353 A1 US 20210338353A1 US 202117325825 A US202117325825 A US 202117325825A US 2021338353 A1 US2021338353 A1 US 2021338353A1
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Classifications
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- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
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- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
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Definitions
- aspects of the present disclosure relate to surgical cannulas having electrical grounding, and related systems and methods.
- Remotely-controlled surgical instruments which can include teleoperated surgical instruments (e.g., surgical instruments operated at least in part with computer assistance, such as instruments operated with robotic technology) as well as manually operated (e.g., laparoscopic, thorascopic) surgical instruments, are often used in minimally invasive medical procedures.
- a surgical instrument which may extend through a cannula inserted into a patient's body, can be remotely manipulated to perform a procedure at a surgical site.
- cannulas and surgical instruments can be mounted at manipulator arms of a patient side cart and be remotely manipulated via teleoperation at a surgeon console.
- Teleoperated surgical instruments may include parts made of metal or other electrically conductive materials. Conductive materials can become electrically charged in a surgical environment. When such an electrical charge discharges, the discharge may occur in undesirable and/or unanticipated locations as the charge seeks a path to a lower electric potential. In addition, a discharge can potentially damage the instrument, particularly if the instrument includes electrical components.
- electrically conductive portions of a surgical cannula are often electrically coupled to the patient's body to dissipate charge from surgical instruments and prevent buildup of electrical charge.
- Such electrical coupling may be achieved by connecting an electrical conductor between the electrically conductive portions of the surgical cannula and the patient's body, and the patient may be electrically coupled to a reference electrical potential associated with an electrosurgical energy generator unit that supplies energy to a surgical instrument that is inserted through the cannula.
- the electrical coupling between the conductive portions of the cannula and the patient's body can be achieved by connecting a conductor (e.g., a cable, wire, etc.) between an electrode in contact with the patient's body and the conductive portions of the cannula.
- Exemplary embodiments of the present disclosure may solve one or more problems and/or may demonstrate one or more desirable features, which will become apparent from the description that follows.
- a surgical cannula includes an electrically conductive portion, an electrical connector interface configured to removably engage with an electrical connector electrically coupled to a patient return electrode, and an electrical connector sensing device configured to sense whether the electrical connector interface is engaged or disengaged with the electrical connector.
- a surgical system includes a surgical manipulator and a cannula.
- the cannula includes an attachment portion configured for attachment to the surgical manipulator, an electrical connector interface configured to removably engage with an electrical connector electrically coupled with a patient return electrode, and an electrical connector sensing device configured to provide information to a controller of the surgical system regarding an engaged or disengaged state of the electrical connector with the electrical connector interface.
- a method includes positioning an electrode in conductive contact with an electrically conductive body and engaging an electrical connector operatively coupled to the electrode to an electrical connector interface of a surgical cannula. Engaging the electrical connector with the electrical connector interface electrically couples the electrical connector and the electrical connector interface of the surgical cannula.
- the method includes changing a state of an electrical connector sensing device responsive to the engaging of the electrical connector and the electrical connector interface of the surgical cannula.
- FIG. 1 is a front view of an exemplary embodiment of a patient side cart of a teleoperated, computer-assisted surgical system
- FIG. 2 is a perspective view of a cannula and a portion of a surgical instrument manipulator according to an exemplary embodiment.
- FIG. 3 is a side diagrammatic view of a cannula and a patient return electrode connector according to an exemplary embodiment.
- FIG. 4 is a perspective view of a cannula according to an exemplary embodiment.
- FIG. 5 is a schematic view of a portion of a cannula and a portion of a surgical instrument manipulator according to an exemplary embodiment.
- FIG. 6 is a schematic view of a portion of a cannula and a portion of a surgical instrument manipulator according to an exemplary embodiment.
- FIG. 7 is a perspective view of a cannula and a portion of a surgical instrument manipulator according to another exemplary embodiment.
- FIG. 8 side diagrammatic view of a cannula and a patient return electrode connector according to another exemplary embodiment.
- FIG. 9 is a diagrammatic view of a portion of a teleoperated surgical system according to an exemplary embodiment.
- spatially relative terms such as “top”, “bottom”, “lower”, “upper”, “below”, “above”, “proximal”, “distal”, and the like—may be used to describe one element's or feature's relationship to another element or feature as illustrated in the orientation of the figures.
- These spatially relative terms are intended to encompass different positions (i.e., locations) and orientations (i.e., rotational placements) of a device in use or operation in addition to the position and orientation shown in the figures. For example, if a device in the figures is inverted, elements described as “below” or “beneath” other elements or features would then be “above” or “over” the other elements or features.
- the exemplary term “below” can encompass both positions and orientations of above and below.
- a device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly.
- the relative proximal and distal directions of surgical instruments are labeled in the figures.
- Various exemplary embodiments of the present disclosure include surgical cannulas configured to provide information to a surgical system regarding a connected state or disconnected state of an electrical conductor, such as an electrode and an associated cable and connector, configured to form a conductive path between an electrically conductive portion of the surgical cannula and a patient's body.
- the electrode in contact with the patient may be characterized as a “return electrode”; for example, while the electrode may in one sense be considered to “ground” the cannula to the patient, the voltage potential of the patient is not necessarily equal to earth ground.
- the connected or disconnected state of the return electrode connector is indicated by the position and/or polarity of one or more magnets disposed within the body of the cannula.
- one or more sensors configured to recognize the presence and/or polarity of a magnet may be included in a component, such as a manipulator arm, of a remotely controlled surgical system.
- the connected or disconnected state of the return electrode connector may be indicated by a radio frequency identification (RFID) device of the cannula, an electromagnetic or optical proximity sensor, or by other techniques.
- RFID radio frequency identification
- Exemplary embodiments described herein may be used, for example, with a teleoperated, computer-assisted surgical system (sometimes referred to as robotic surgical systems) such as that described in, for example, U.S. Patent App. Pub. No. US 2013/0325033 A1, entitled “Multi-Port Surgical Robotic System Architecture” and published on Dec. 5, 2013, U.S. Patent App. Pub. No. US 2013/0325031 A1, entitled “Redundant Axis and Degree of Freedom for Hardware-Constrained Remote Center Robotic Manipulator” and published on Dec. 5, 2013, and U.S. Pat. No. 8,852,208, entitled “Surgical System Instrument Mounting” and published on Oct. 7, 2014, each of which is hereby incorporated by reference in its entirety.
- the exemplary embodiments described herein may be used, for example, with a da Vinci® Surgical System, such as the da Vinci Si® Surgical System or the da Vinci Xi® Surgical System, both with or without Single-Site® single orifice surgery technology, all commercialized by Intuitive Surgical, Inc.
- a da Vinci® Surgical System such as the da Vinci Si® Surgical System or the da Vinci Xi® Surgical System
- Single-Site® single orifice surgery technology all commercialized by Intuitive Surgical, Inc.
- various exemplary embodiments described herein are discussed with regard to surgical instruments used with a patient side cart of a teleoperated surgical system, the present disclosure is not limited to use with surgical instruments for a teleoperated surgical system.
- various exemplary embodiments of surgical cannulas described herein can optionally be used in conjunction with hand-held, manual surgical instruments.
- a teleoperated surgical system may further include a surgeon console (not shown) for receiving input from a user to control instruments mounted at patient side cart 1000 .
- patient side cart 1000 includes a base 1020 and a main column 1040 .
- the patient side cart 1000 also includes a plurality of teleoperated manipulator arms 1100 , 1110 , 1120 , 1130 (sometimes referred to as patient side manipulators), which are each connected to the main column 1040 as depicted in the exemplary embodiment of FIG. 1 .
- Manipulator arms 1100 , 1110 , 1120 , 1130 may each include an instrument mount portion 1200 to which an instrument 1300 may be mounted. Portions of the manipulator arms 1100 , 1110 , 1120 , 1130 may be manipulated during a surgical procedure according to commands provided by a user at the surgeon console.
- signal(s) or input(s) transmitted from a surgeon console are transmitted to the control/vision cart, which interprets the input(s) and generate command(s) or output(s) to be transmitted to the patient side cart 1000 to cause manipulation of an instrument 1300 (only one such instrument being mounted in FIG. 1 ) and/or portions of manipulator arm 1100 to which the instrument 1300 is coupled at the patient side cart 1000 .
- Instrument mount portion 1200 may comprise an actuation interface assembly 1220 and a cannula mount 1240 .
- a shaft 1320 of instrument 1300 extends through cannula mount 1240 and mounted cannula, and on to a remote site during a surgical procedure.
- a force transmission mechanism 1340 at a proximal end of instrument 1300 is mechanically coupled with the actuation interface assembly 1220 , according to an exemplary embodiment.
- Surgical instrument force transmission mechanisms which receive a mechanical input force from a source (e.g., an electric motor on a manipulator arm supporting the instrument) and convert and/or redirect the received force to an output force to drive a component (e.g., a wrist, an end effector, etc.) at a relatively distal end portion of the instrument.
- Cannula mount 1240 may be configured to hold a cannula 1360 through which shaft 1320 of instrument 1300 may extend to a surgery site during a surgical procedure.
- Actuation interface assembly 1220 may contain a variety of drive and other mechanisms that are controlled to respond to input commands at the surgeon console and transmit forces to the force transmission mechanism 1340 to actuate instrument 1300 , as those skilled in the art are familiar with.
- the cannula 100 includes a bowl portion 102 forming a proximal end 104 of the cannula and a tube 106 extending from the bowl portion 102 to a distal end 108 of the cannula 100 .
- a portion of the cannula 100 may be inserted at least partially through an opening in a patient's body to a surgical site.
- the distal end 108 of the cannula 100 may be inserted through an opening, such as an incision or natural orifice, with or without a surgical port, to the surgical site.
- a surgical instrument e.g., surgical instrument 1300 shown in FIG. 1
- the cannula 100 may include a return electrode connector interface 110 configured to accept a return electrode connector 112 ( FIG. 3 ).
- the return electrode connector interface 110 may include one or more electrical contacts 114 configured to conductively couple with mating electrical contacts (not shown) of the return electrode connector 112 .
- the return electrode connector interface 110 may also be characterized as a complementary electrical connector.
- the electrical contacts 114 may form a portion of a conductive path between electrically conductive portions of the cannula 100 and a body of a patient through a conductor (e.g., wire) 116 ( FIG. 3 ) connected to an electrode conductively coupled to a patient's body (e.g., electrode 650 shown in FIG. 9 ).
- the interface 110 may be configured as a female connector portion (e.g., a receptacle) and the return electrode connector 112 may be configured as a male connector portion (e.g., a plug).
- the interface may be configured as a male connector portion (e.g., a plug) and the return electrode connector 112 may be configured as a female connector portion (e.g., a receptacle).
- the cannula 100 may include an attachment portion 118 configured to attach the cannula 100 to a component (e.g., patient side manipulator or arm) of a surgical system, such as that described in detail in Intl Pub. No. WO2015/0142812, filed Mar. 17, 2015 and entitled “Surgical Cannulas and Related Systems and Methods of Identifying Surgical Cannulas,” which is incorporated by reference herein in its entirety.
- the attachment portion 118 of the cannula 100 may be configured to be inserted within a receptacle 120 of a manipulator arm 122 (e.g., manipulator arm 1100 ( FIG. 1 )) (also called “manipulator 122 ”) of a patient side cart.
- the attachment portion 118 When inserted within the manipulator arm receptacle 120 , the attachment portion 118 may be electrically insulated from the manipulator arm 122 .
- the cannula 100 may include a sensing system (e.g., sensing device, sensing component, etc.) configured to provide information relating to the connected or disconnected status of the return electrode connector 111 with the return electrode connector interface 110 of the cannula 100 .
- the provided information is transmitted through the manipulator arm 122 to the teleoperated surgical system, and the teleoperated surgical system indicates the connected or disconnected status of the return electrode connector 111 to an operator (e.g., nurse, surgeon, technician, etc.) with a visual indicator such as a warning light or a message on a display screen, an audible indicator such as an alarm, or another indicator.
- a visual indicator such as a warning light or a message on a display screen
- an audible indicator such as an alarm, or another indicator.
- Such an indicator may be included in a display portion (not shown) of the teleoperated surgical system.
- the teleoperated surgical system may include a lockout system configured to disable a function of a surgical instrument when the return electrode connector 111 is determined to be in a disconnected state from the interface 110 .
- the surgical system may be configured to prevent application of electrical power to a surgical instrument (e.g., surgical instrument 646 shown in FIG. 9 ), such as an electrocautery tool, when the return electrode connector 111 is not connected at the return electrode connector interface 110 of the cannula 100 .
- a surgical instrument e.g., surgical instrument 646 shown in FIG. 9
- the sensing system can include one or more of mechanical devices, optical devices, electrical devices, magnetic devices and/or other sensing devices.
- the sensing system may include a component of the cannula 100 configured to be recognized by a sensor in the manipulator arm 122 of the teleoperated surgical system.
- the sensing component of the cannula 100 may be configured to be recognized by one or more of a proximity sensor, such as a photoelectric or electromagnetic sensor, a radio-frequency identification (RFID) sensor, a Hall-effect sensor, etc. of the manipulator arm 122 .
- a proximity sensor such as a photoelectric or electromagnetic sensor, a radio-frequency identification (RFID) sensor, a Hall-effect sensor, etc.
- the sensing component may be configured to change from a first state to a second state when the return electrode connector 112 is in a connected state with the return electrode connector receptacle comprising the return electrode connector interface 110 of the cannula 100 .
- the first state and the second state may include, for example, a position, orientation, or other physical configuration of the sensing component, an electrical or magnetic state of the component, etc.
- the first state and the second state may refer to physical positions and/or orientations of a magnet sensed by, e.g., a hall-effect sensor or other magnetic sensor, a shutter or other component sensed by a proximity sensor, etc.
- the first state and the second state may refer to energized and non-energized states of a passive RFID tag, transmitting and non-transmitting states of a battery-assisted passive RFID tag, etc.
- changing the state of the electrical connector sensing device includes changing radio-frequency electromagnetic waves (e.g., those being emitted by an RFID tag) being sensed by an electrical connector sensing device (e.g., an RFID sensor).
- the return electrode connector interface 110 is positioned laterally opposite to the attachment portion 118 of the cannula 100 .
- cannula 200 has a mechanical device 224 located between the attachment portion 118 of the cannula 200 and a return electrode connector interface 210 (also called “return electrode connector receptacle 210 ” in various embodiments).
- the mechanical device 224 is configured to alter in position and/or configuration when the return electrode connector 112 is engaged (e.g., mated) with the return electrode connector interface 210 , such as being inserted within a receptacle of the return electrode connector interface 210 .
- the position and/or orientation of a component within or near the attachment portion 118 of the cannula may be altered by the mechanical device 224 responsive to the act of engaging or disengaging the return electrode connector 112 with the return electrode connector 112 .
- the cannula 200 includes a pushrod 230 extending laterally across a portion of the cannula 200 from the return electrode connector interface 210 to the attachment portion 118 .
- the pushrod 230 may be in contact with a plunger 226 that is configured to extend at least partially into the return electrode connector receptacle 210 when the return electrode connector is not located within the return electrode connector receptacle 210 .
- Insertion of the return electrode connector 112 within the return electrode connector receptacle 210 may cause the return electrode connector 112 to push against the plunger 226 , forcing the plunger 226 to move downward (i.e., in a direction away from the return electrode connector 112 and generally parallel to a longitudinal axis of the cannula 200 ).
- Interaction between the pushrod 230 and the plunger 226 may convert the longitudinal motion of the plunger 226 to lateral movement in the pushrod 230 , forcing the pushrod 230 to move in direction 232 .
- complementary inclined planes 227 of the pushrod 230 and the plunger 226 convert the longitudinal motion of the plunger 226 to lateral movement of the pushrod 230 .
- insertion of the return electrode connector 112 within the return electrode connector receptacle 210 causes the pushrod 230 to move from a position representing a disconnected state of the return electrode connector 112 , to another position along direction 232 representing a connected state of the return electrode connector 112 .
- Movement of the pushrod 230 in turn changes the position and/or orientation of a sensing device disposed within the attachment portion 118 , as discussed in greater detail in connection with the exemplary embodiments of FIGS. 3 and 4 below.
- the pushrod 230 and the plunger 226 are a single rigid part configured to translate laterally as a unit in response to the return electrode connector being engaged with the return electrode interface 210 .
- the pushrod 230 may be replaced by a pivoting lever, or by any other mechanism configured to transfer movement between the return electrode connector 112 and an sensing device within the attachment portion 118 .
- the pushrod 230 or other mechanism of the sensing system, is biased, e.g., by a spring or other biasing element, to ensure that the sensing system returns to a position representing the disconnected state of the return electrode connector 112 when the return electrode connector 112 is removed from the return electrode connector receptacle 210 .
- the attachment portion 118 of the surgical cannula 200 may include an array of magnets 336 (e.g., a 2 ⁇ 2 array being depicted) (also called “array 336 ”).
- the array of magnets 336 and related portions of the surgical cannula 200 may be substantially as described at least in Intl Pub. No. WO 2015/0142812, as incorporated by reference above.
- the array of magnets 336 is configured to interact with sensors (e.g., Hall-effect sensors) disposed within a manipulator (e.g., manipulator 122 ( FIG.
- the presence, absence, and/or polarity of each magnet of the array of magnets 336 can be associated with a particular aspect of the cannula 200 such as bowl diameter, length, shape of tube, number of uses, etc.
- Sensors within the manipulator 122 transmit information regarding the presence and/or polarity of each magnet of the array 336 to the surgical system, where information regarding the particular combination of magnets and polarity is utilized by a processor or controller and memory to identify the configuration and/or state of the cannula 200 .
- the information provided to the surgical system by the array of magnets 336 include the connected or disconnected state of the return electrode connector 112 .
- the combination of presence and/or polarity of the magnets of the array 336 can be used to identify the particular design of the cannula 200 (e.g., bowl diameter, tube length, shape of tube, etc.) and the position and/or polarity of one or more magnets of the array 336 also indicates whether the return electrode connector 112 is in a connected state with the cannula 200 .
- a magnet 338 of the array 336 is mechanically coupled with the pushrod 230 ( FIG. 3 ), such that movement of the pushrod 230 (e.g., as the return electrode connector 112 is inserted within or removed from the return electrode connector receptacle 210 ( FIG. 3 )) causes a corresponding movement of the magnet 338 .
- the magnet 338 may be mechanically coupled directly with the pushrod 230 or through a linkage, a rack and pinion gear, etc., or any other suitable mechanical device.
- Movement of the pushrod 230 from a first position associated with the absence of the return electrode connector 112 from the return electrode connector receptacle 210 to a second position associated with the presence of the return electrode connector 112 within the return electrode connector receptacle comprising the return electrode connector interface 110 thereby moves the magnet 338 from a first position, configuration, and/or orientation to a second position, configuration, and/or orientation in a manner recognized by a sensor within the manipulator 122 ( FIG. 2 ).
- movement of the magnet 338 comprises translational movement from a first position within the attachment portion 118 to a second position within the attachment portion 118 .
- the magnet 338 In the first position, the magnet 338 is positioned proximate (e.g., within a sensing range of) a sensor, such as a Hall-effect sensor 123 ( FIG. 2 ), within the receptacle 120 ( FIG. 2 ) of the manipulator arm 122 ( FIG. 2 ) when the attachment portion 118 is disposed within the receptacle 120 .
- the magnet 338 is positioned out of the sensing range of the sensor 123 when the attachment portion 118 is disposed within the receptacle 120 .
- inserting the return electrode connector 112 within the return electrode connector receptacle 210 moves the magnet 338 from a first position in which the magnet 338 is within a sensing range of the sensor 123 in the manipulator 122 , to a second position in which the magnet 336 is not within the sensing range of the sensor 123 in the manipulator 122 .
- the presence or absence of the magnet 338 from the sensing range of the sensor 123 indicates to the surgical system the connected or disconnected status of the return electrode connector 112 .
- a pushrod 530 supports a magnet 538 , which may, in some exemplary embodiments, form a portion of an array of magnets (e.g., array 336 shown in FIG. 4 ).
- the pushrod 530 is configured to move along direction 532 as a return electrode connector (e.g., the return electrode connector 111 in FIG. 2 ) is engaged with, or removed from, a return electrode connector interface (e.g., the return electrode connector interface 110 in FIG. 3 ).
- a return electrode connector e.g., the return electrode connector 111 in FIG. 2
- a return electrode connector interface e.g., the return electrode connector interface 110 in FIG. 3
- the magnet 538 may be disposed proximate (e.g., within a sensing range of) a sensor 523 (similar to, e.g., sensor 123 discussed in connection with FIG. 2 ) when the pushrod 530 is in a position associated with the return electrode connector being engaged with the return electrode connector interface, as shown in solid lines in FIG. 5 .
- a sensor 523 similar to, e.g., sensor 123 discussed in connection with FIG. 2
- the pushrod 530 and magnet 538 are positioned as shown in the dashed lines in FIG. 5 , and the magnet 538 is positioned outside of a sensing range of the sensor 523 .
- Information regarding the position of the magnet 538 within, or outside of, the sensing range of the sensor 523 is processed by the surgical system to provide, e.g., a warning indication at a user interface (not shown) of the surgical system, a lockout condition, etc.
- movement of the magnet 338 may comprise movement that changes the pole of the magnet 338 presented to the sensor 123 of the receptacle 120 of the manipulator 122 ( FIG. 2 ). For example, in a first rotational position, one of the north pole and the south pole of the magnet is proximate the sensor 123 within the receptacle 120 of the manipulator 122 . Movement of the pushrod 230 causes the magnet 336 to rotate until the other of the north pole and south pole is proximate the sensor 123 . Accordingly, the polarity of the magnet 338 presented to the sensor 123 may be used to determine the connected or disconnected status of the return electrode connector 112 .
- FIG. 6 a schematic view of another exemplary embodiment of a portion of a return electrode sensing system 601 is shown.
- a pushrod 630 is connected to a magnet 638 by a rack 625 and pinion 626 gear set.
- the magnet 638 is rotatably attached (e.g., by a bearing, pin, etc.) to a cannula (e.g., at an attachment portion such as attachment portion 118 of cannula 100 ( FIG. 2 )) and positioned proximate a sensor 623 when the attachment portion 118 is engaged with the portion of the manipulator arm 122 ( FIG. 2 ).
- the pushrod 630 moves along direction 632 as a return electrode connector (e.g., the return electrode connector 111 in FIG. 2 ) is engaged with, or disengaged from, a return electrode connector interface (e.g., the return electrode connector interface 110 in FIG. 3 ).
- Linear movement of the pushrod 630 is converted to rotational movement of the magnet 638 through the rack 625 and pinion 626 gear set.
- the pinion gear 626 and magnet 638 rotate together about a rotational axis 627 of the pinion gear 626 , as indicated by directional arrows 628 .
- the magnet 638 has a north pole N and a south pole S.
- the south pole S of the magnet 638 is positioned proximate the sensor 623 when the return electrode connector 111 is engaged with the return electrode connector interface 110 .
- movement of the pushrod 630 and the rack 625 causes the pinion 626 and magnet 638 to rotate 180 degrees, positioning the north pole N of the magnet 638 proximate the sensor 623 .
- Information regarding which pole of the magnet 638 is positioned proximate the sensor 623 may be processed by the surgical system, and the surgical system user interface may provide a warning or lockout condition based on the connected or disconnected status of the return electrode connector 111 .
- any number or combinations of magnets of the array of magnets 336 may be configured to indicate the connected or disconnected state of the return electrode connector 112 .
- FIG. 7 illustrates another exemplary embodiment of a surgical cannula 400 according to the disclosure.
- the surgical cannula 400 may have similar parts as surgical cannula 200 described in connection with FIGS. 3 through 4 .
- the surgical cannula 400 includes a shutter 438 positioned in an opening 440 of an attachment portion 418 of the cannula 400 .
- the shutter 438 is configured to move between a first position, in which the shutter 438 is outside of sensing proximity of a proximity sensor 442 disposed in a manipulator arm 422 , and a second position, in which the shutter 438 is within sensing proximity of the proximity sensor 442 .
- the proximity sensor 442 may comprise, for example, one or more of an optical proximity sensor, an electromagnetic proximity sensor, etc.
- Movement of the shutter 438 between the first position and the second position may be caused by mating of a return electrode connector (e.g., return electrode connector 112 shown in FIG. 3 ) with a return electrode connector interface.
- a return electrode connector e.g., return electrode connector 112 shown in FIG. 3
- the cannula 400 includes a return electrode connector interface 410 similar to the interface 110 described above in connection with FIG. 2 .
- movement of the shutter 438 may be effected by a mechanism similar to the pushrod 230 described in connection with FIG. 3 .
- Information regarding the connected or disconnected state of the return electrode connector may thus be provided in a manner otherwise similar to that discussed above in connection with the embodiment of FIGS. 2 through 4 .
- the cannula 400 may also include an array of magnets similar to the array of magnets 336 described in connection with FIG. 4 .
- Such an array may be similarly configured to provide information regarding various parameters of the cannula 400 to a surgical system of which the manipulator arm 422 forms a part as described above in connection with FIG. 4 .
- use of such a magnet array is optional.
- the return electrode connector 512 includes a radio frequency identification (RFID) tag 544 configured and positioned to be recognized by an RFID sensor (not shown) positioned on a manipulator (e.g., manipulator 122 shown in FIG. 2 ) when the return electrode connector 512 is within a specified range of the RFID sensor.
- RFID radio frequency identification
- the RFID tag 544 of the return electrode connector 512 is within the specified range of the RFID sensor when the return electrode connector 512 is engaged with a return electrode connector interface 510 , and the RFID tag 544 is outside of the specified range of the RFID sensor when the return electrode connector 512 is disconnected from mating engagement with the return electrode connector interface 510 , such as being removed from mating engagement with the return electrode connector interface 510 .
- the RFID sensor within the manipulator may recognize the absence of the RFID tag 544 of the return electrode connector 512 .
- the surgical system may provide a visual or audible indication, or a lockout condition, based on the disconnected state of the return electrode connector 512 .
- the electrical connector interface 110 , 210 , 410 , and 510 is configured as a receptacle (i.e., female connector portion), and the connector 111 , 112 , and 512 is a plug (i.e., male connector portion) configured for insertion within the receptacle.
- a receptacle i.e., female connector portion
- the connector 111 , 112 , and 512 is a plug (i.e., male connector portion) configured for insertion within the receptacle.
- the connector interface 110 , 210 , 410 , and 510 may be configured as a plug and the electrical connector 111 , 112 , and 512 may be configured as a receptacle.
- Other exemplary embodiments may include different configurations of plugs and receptacles, or any other configuration of components configured to form an electrical and/or mechanical connection as described above.
- FIG. 9 is a diagrammatic view of an exemplary teleoperated surgical system, with a cannula 600 and an instrument 646 shown in place on a surgical system 664 as well as in detail view.
- the cannula 600 illustrated in FIG. 9 can be any one of cannulas 100 , 200 , 400 , or 500 , illustrated in FIGS. 2 through 4, 7 and 8 .
- Return electrodes 648 and 650 are disposed beneath a patient 652 positioned on an operating table 654 , for example, beneath the patient's shoulders and buttocks, or at other locations that provide sufficient surface area contact between the return electrodes 648 and 650 and the patient's body so as to permit electrical conductance therebetween.
- the return electrode 648 also is electrically coupled to an electrosurgical generator unit 656 through a cable 658 .
- the electrode 650 is configured to be electrically coupled to the cannula 600 through a return electrode connector 612 of a cable 660 configured to connect with a return electrode connector interface 610 of the cannula 600 . Such connection forms an electrical contact between the patient 652 and the cannula 600 . An electrically conductive path is thus created from the cannula 600 to the patient 652 through the electrode 650 , and to the electrosurgical generator unit 656 from the electrode 648 .
- the cannula 600 is configured to be disposed within an incision or orifice of the patient 652 , such as within a surgical port (not shown).
- the instrument 646 may include a shaft 662 extending through the cannula 600 with an end effector 663 configured to perform a function such as, for example, stapling, cutting, cauterizing, suturing, clamping, etc., or combinations thereof.
- the cannula 600 and instrument 646 may be connected to a patient side manipulator 664 , such as those disclosed at least in Intl Pub. No. WO2015/0142812, U.S. Patent App. Pub. No. US 2013/0325033, U.S. Patent App. Pub. No. US 2013/0325031, and U.S. Pat. No. 8,852,208, each of which is incorporated by reference above.
- the cannula 600 and the patient side manipulator 664 may include a return electrode connection sensing system according to any of the exemplary embodiments described above in connection with FIGS. 2 through 8 .
- a return electrode connection sensing system may be configured to sense the engaged or disengaged state of the return electrode connector 612 with the return electrode connector interface 610 of the cannula 600 , as described in the exemplary embodiments above.
- the patient side manipulator 664 may be configured to provide various safety notifications and/or interlocks based on the engaged or disengaged state of the return electrode connector 612 with the return electrode connector interface 610 of the cannula 600 .
- a user interface (not shown) associated with the patient side manipulator 664 may be configured to provide a visual and/or audible notification to alert a user of the engaged or disengaged state of the return electrode connector interface 610 with the cannula 600 .
- the user interface and/or the patient side manipulator may be configured to prevent application of electrical energy to the end effector 663 when the return electrode connector 612 is disengaged from the return electrode connector interface 610 of the cannula 600 .
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Abstract
A method comprise positioning an electrode in conductive contact with an electrically conductive body; engaging an electrical connector operatively coupled to the electrode to an electrical connector interface of a surgical cannula; and changing a state of an electrical connector sensing device responsive to the engaging of the electrical connector and the electrical connector interface of the surgical cannula. The engaging electrically couples the electrical connector and the electrical connector interface of the surgical cannula.
Description
- This application is a continuation application of application Ser. No. 15/624,148, filed Jun. 15, 2017, which claims priority to U.S. Provisional Application No. 62/364,563, filed Jul. 20, 2016 (now expired), each of which is incorporated by reference herein in their entirety.
- Aspects of the present disclosure relate to surgical cannulas having electrical grounding, and related systems and methods.
- Remotely-controlled surgical instruments, which can include teleoperated surgical instruments (e.g., surgical instruments operated at least in part with computer assistance, such as instruments operated with robotic technology) as well as manually operated (e.g., laparoscopic, thorascopic) surgical instruments, are often used in minimally invasive medical procedures. During such procedures, a surgical instrument, which may extend through a cannula inserted into a patient's body, can be remotely manipulated to perform a procedure at a surgical site. For example, in a teleoperated surgical system, cannulas and surgical instruments can be mounted at manipulator arms of a patient side cart and be remotely manipulated via teleoperation at a surgeon console.
- Teleoperated surgical instruments may include parts made of metal or other electrically conductive materials. Conductive materials can become electrically charged in a surgical environment. When such an electrical charge discharges, the discharge may occur in undesirable and/or unanticipated locations as the charge seeks a path to a lower electric potential. In addition, a discharge can potentially damage the instrument, particularly if the instrument includes electrical components.
- Accordingly, electrically conductive portions of a surgical cannula are often electrically coupled to the patient's body to dissipate charge from surgical instruments and prevent buildup of electrical charge. Such electrical coupling may be achieved by connecting an electrical conductor between the electrically conductive portions of the surgical cannula and the patient's body, and the patient may be electrically coupled to a reference electrical potential associated with an electrosurgical energy generator unit that supplies energy to a surgical instrument that is inserted through the cannula. The electrical coupling between the conductive portions of the cannula and the patient's body can be achieved by connecting a conductor (e.g., a cable, wire, etc.) between an electrode in contact with the patient's body and the conductive portions of the cannula.
- It is desirable to improve upon cannula electrical grounding to facilitate surgical procedures using electrical energy.
- Exemplary embodiments of the present disclosure may solve one or more problems and/or may demonstrate one or more desirable features, which will become apparent from the description that follows.
- In accordance with various exemplary embodiments, a surgical cannula includes an electrically conductive portion, an electrical connector interface configured to removably engage with an electrical connector electrically coupled to a patient return electrode, and an electrical connector sensing device configured to sense whether the electrical connector interface is engaged or disengaged with the electrical connector.
- In accordance with various exemplary embodiments, a surgical system includes a surgical manipulator and a cannula. The cannula includes an attachment portion configured for attachment to the surgical manipulator, an electrical connector interface configured to removably engage with an electrical connector electrically coupled with a patient return electrode, and an electrical connector sensing device configured to provide information to a controller of the surgical system regarding an engaged or disengaged state of the electrical connector with the electrical connector interface.
- In accordance with various exemplary embodiments, a method includes positioning an electrode in conductive contact with an electrically conductive body and engaging an electrical connector operatively coupled to the electrode to an electrical connector interface of a surgical cannula. Engaging the electrical connector with the electrical connector interface electrically couples the electrical connector and the electrical connector interface of the surgical cannula. The method includes changing a state of an electrical connector sensing device responsive to the engaging of the electrical connector and the electrical connector interface of the surgical cannula.
- Additional objects, features, and/or advantages will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the present disclosure and/or claims. At least some of these objects and advantages may be realized and attained by the elements and combinations particularly pointed out in the appended claims.
- Both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the claims; rather, the claims should be entitled to their full breadth of scope, including equivalents.
- The present disclosure can be understood from the following detailed description, either alone or together with the accompanying drawings. The drawings are included to provide a further understanding of the present disclosure, and are incorporated in and constitute a part of this specification. The drawings illustrate one or more exemplary embodiments of the present teachings and together with the description serve to explain certain principles and operation.
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FIG. 1 is a front view of an exemplary embodiment of a patient side cart of a teleoperated, computer-assisted surgical system; -
FIG. 2 is a perspective view of a cannula and a portion of a surgical instrument manipulator according to an exemplary embodiment. -
FIG. 3 is a side diagrammatic view of a cannula and a patient return electrode connector according to an exemplary embodiment. -
FIG. 4 is a perspective view of a cannula according to an exemplary embodiment. -
FIG. 5 is a schematic view of a portion of a cannula and a portion of a surgical instrument manipulator according to an exemplary embodiment. -
FIG. 6 is a schematic view of a portion of a cannula and a portion of a surgical instrument manipulator according to an exemplary embodiment. -
FIG. 7 is a perspective view of a cannula and a portion of a surgical instrument manipulator according to another exemplary embodiment. -
FIG. 8 side diagrammatic view of a cannula and a patient return electrode connector according to another exemplary embodiment. -
FIG. 9 is a diagrammatic view of a portion of a teleoperated surgical system according to an exemplary embodiment. - This description and the accompanying drawings that illustrate exemplary embodiments should not be taken as limiting. Various mechanical, compositional, structural, electrical, and operational changes may be made without departing from the scope of this description and the claims, including equivalents. In some instances, well-known structures and techniques have not been shown or described in detail so as not to obscure the disclosure. Like numbers in two or more figures represent the same or similar elements. Furthermore, elements and their associated features that are described in detail with reference to one embodiment may, whenever practical, be included in other embodiments in which they are not specifically shown or described. For example, if an element is described in detail with reference to one embodiment and is not described with reference to a second embodiment, the element may nevertheless be claimed as included in the second embodiment.
- For the purposes of this specification and appended claims, unless otherwise indicated, all numbers expressing quantities, percentages, or proportions, and other numerical values used in the specification and claims, are to be understood as being modified in all instances by the term “about,” to the extent they are not already so modified. Accordingly, unless indicated to the contrary, the numerical parameters set forth in the following specification and attached claims are approximations that may vary depending upon the desired properties sought to be obtained. At the very least, and not as an attempt to limit the application of the doctrine of equivalents to the scope of the claims, each numerical parameter should at least be construed in light of the number of reported significant digits and by applying ordinary rounding techniques.
- It is noted that, as used in this specification and the appended claims, the singular forms “a,” “an,” and “the,” and any singular use of any word, include plural referents unless expressly and unequivocally limited to one referent. As used herein, the term “include” and its grammatical variants are intended to be non-limiting, such that recitation of items in a list is not to the exclusion of other like items that can be substituted or added to the listed items.
- Further, this description's terminology is not intended to limit the disclosure or claims. For example, spatially relative terms—such as “top”, “bottom”, “lower”, “upper”, “below”, “above”, “proximal”, “distal”, and the like—may be used to describe one element's or feature's relationship to another element or feature as illustrated in the orientation of the figures. These spatially relative terms are intended to encompass different positions (i.e., locations) and orientations (i.e., rotational placements) of a device in use or operation in addition to the position and orientation shown in the figures. For example, if a device in the figures is inverted, elements described as “below” or “beneath” other elements or features would then be “above” or “over” the other elements or features. Thus, the exemplary term “below” can encompass both positions and orientations of above and below. A device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. The relative proximal and distal directions of surgical instruments are labeled in the figures.
- Various exemplary embodiments of the present disclosure include surgical cannulas configured to provide information to a surgical system regarding a connected state or disconnected state of an electrical conductor, such as an electrode and an associated cable and connector, configured to form a conductive path between an electrically conductive portion of the surgical cannula and a patient's body. The electrode in contact with the patient may be characterized as a “return electrode”; for example, while the electrode may in one sense be considered to “ground” the cannula to the patient, the voltage potential of the patient is not necessarily equal to earth ground. In accordance with an exemplary embodiment of the disclosure, the connected or disconnected state of the return electrode connector is indicated by the position and/or polarity of one or more magnets disposed within the body of the cannula. For example, one or more sensors configured to recognize the presence and/or polarity of a magnet may be included in a component, such as a manipulator arm, of a remotely controlled surgical system. In some embodiments, the connected or disconnected state of the return electrode connector may be indicated by a radio frequency identification (RFID) device of the cannula, an electromagnetic or optical proximity sensor, or by other techniques.
- Exemplary embodiments described herein may be used, for example, with a teleoperated, computer-assisted surgical system (sometimes referred to as robotic surgical systems) such as that described in, for example, U.S. Patent App. Pub. No. US 2013/0325033 A1, entitled “Multi-Port Surgical Robotic System Architecture” and published on Dec. 5, 2013, U.S. Patent App. Pub. No. US 2013/0325031 A1, entitled “Redundant Axis and Degree of Freedom for Hardware-Constrained Remote Center Robotic Manipulator” and published on Dec. 5, 2013, and U.S. Pat. No. 8,852,208, entitled “Surgical System Instrument Mounting” and published on Oct. 7, 2014, each of which is hereby incorporated by reference in its entirety. Further, the exemplary embodiments described herein may be used, for example, with a da Vinci® Surgical System, such as the da Vinci Si® Surgical System or the da Vinci Xi® Surgical System, both with or without Single-Site® single orifice surgery technology, all commercialized by Intuitive Surgical, Inc. Although various exemplary embodiments described herein are discussed with regard to surgical instruments used with a patient side cart of a teleoperated surgical system, the present disclosure is not limited to use with surgical instruments for a teleoperated surgical system. For example, various exemplary embodiments of surgical cannulas described herein can optionally be used in conjunction with hand-held, manual surgical instruments.
- Referring now to
FIG. 1 , an exemplary embodiment of apatient side cart 1000 of a teleoperated, computer-assisted surgical system is shown. A teleoperated surgical system may further include a surgeon console (not shown) for receiving input from a user to control instruments mounted atpatient side cart 1000. According to an exemplary embodiment,patient side cart 1000 includes abase 1020 and amain column 1040. Thepatient side cart 1000 also includes a plurality ofteleoperated manipulator arms main column 1040 as depicted in the exemplary embodiment ofFIG. 1 .Manipulator arms instrument mount portion 1200 to which aninstrument 1300 may be mounted. Portions of themanipulator arms patient side cart 1000 to cause manipulation of an instrument 1300 (only one such instrument being mounted inFIG. 1 ) and/or portions ofmanipulator arm 1100 to which theinstrument 1300 is coupled at thepatient side cart 1000. -
Instrument mount portion 1200 may comprise anactuation interface assembly 1220 and acannula mount 1240. Ashaft 1320 ofinstrument 1300 extends throughcannula mount 1240 and mounted cannula, and on to a remote site during a surgical procedure. Aforce transmission mechanism 1340 at a proximal end ofinstrument 1300 is mechanically coupled with theactuation interface assembly 1220, according to an exemplary embodiment. Persons skilled in the art are familiar with surgical instrument force transmission mechanisms, which receive a mechanical input force from a source (e.g., an electric motor on a manipulator arm supporting the instrument) and convert and/or redirect the received force to an output force to drive a component (e.g., a wrist, an end effector, etc.) at a relatively distal end portion of the instrument.Cannula mount 1240 may be configured to hold acannula 1360 through whichshaft 1320 ofinstrument 1300 may extend to a surgery site during a surgical procedure.Actuation interface assembly 1220 may contain a variety of drive and other mechanisms that are controlled to respond to input commands at the surgeon console and transmit forces to theforce transmission mechanism 1340 to actuateinstrument 1300, as those skilled in the art are familiar with. - Referring now to
FIG. 2 , acannula 100 according to an embodiment of the disclosure is shown. Thecannula 100 includes abowl portion 102 forming aproximal end 104 of the cannula and atube 106 extending from thebowl portion 102 to adistal end 108 of thecannula 100. A portion of thecannula 100 may be inserted at least partially through an opening in a patient's body to a surgical site. For example, thedistal end 108 of thecannula 100 may be inserted through an opening, such as an incision or natural orifice, with or without a surgical port, to the surgical site. A surgical instrument (e.g.,surgical instrument 1300 shown inFIG. 1 ) may be inserted into theproximal end 104 of thecannula 100 and extended through thebowl portion 102, thetube 106, and out through thedistal end 108 of thecannula 100 to a surgical site. - The
cannula 100 may include a returnelectrode connector interface 110 configured to accept a return electrode connector 112 (FIG. 3 ). The returnelectrode connector interface 110 may include one or moreelectrical contacts 114 configured to conductively couple with mating electrical contacts (not shown) of thereturn electrode connector 112. The returnelectrode connector interface 110 may also be characterized as a complementary electrical connector. Theelectrical contacts 114 may form a portion of a conductive path between electrically conductive portions of thecannula 100 and a body of a patient through a conductor (e.g., wire) 116 (FIG. 3 ) connected to an electrode conductively coupled to a patient's body (e.g.,electrode 650 shown inFIG. 9 ). - In exemplary embodiments, the
interface 110 may be configured as a female connector portion (e.g., a receptacle) and thereturn electrode connector 112 may be configured as a male connector portion (e.g., a plug). Alternatively, the interface may be configured as a male connector portion (e.g., a plug) and thereturn electrode connector 112 may be configured as a female connector portion (e.g., a receptacle). - The
cannula 100 may include anattachment portion 118 configured to attach thecannula 100 to a component (e.g., patient side manipulator or arm) of a surgical system, such as that described in detail in Intl Pub. No. WO2015/0142812, filed Mar. 17, 2015 and entitled “Surgical Cannulas and Related Systems and Methods of Identifying Surgical Cannulas,” which is incorporated by reference herein in its entirety. For example, as shown inFIG. 2 , theattachment portion 118 of thecannula 100 may be configured to be inserted within areceptacle 120 of a manipulator arm 122 (e.g., manipulator arm 1100 (FIG. 1 )) (also called “manipulator 122”) of a patient side cart. When inserted within themanipulator arm receptacle 120, theattachment portion 118 may be electrically insulated from themanipulator arm 122. - The
cannula 100 may include a sensing system (e.g., sensing device, sensing component, etc.) configured to provide information relating to the connected or disconnected status of thereturn electrode connector 111 with the returnelectrode connector interface 110 of thecannula 100. The provided information is transmitted through themanipulator arm 122 to the teleoperated surgical system, and the teleoperated surgical system indicates the connected or disconnected status of thereturn electrode connector 111 to an operator (e.g., nurse, surgeon, technician, etc.) with a visual indicator such as a warning light or a message on a display screen, an audible indicator such as an alarm, or another indicator. Such an indicator may be included in a display portion (not shown) of the teleoperated surgical system. Additionally or alternatively, the teleoperated surgical system may include a lockout system configured to disable a function of a surgical instrument when thereturn electrode connector 111 is determined to be in a disconnected state from theinterface 110. For example, the surgical system may be configured to prevent application of electrical power to a surgical instrument (e.g.,surgical instrument 646 shown inFIG. 9 ), such as an electrocautery tool, when thereturn electrode connector 111 is not connected at the returnelectrode connector interface 110 of thecannula 100. - The sensing system can include one or more of mechanical devices, optical devices, electrical devices, magnetic devices and/or other sensing devices. As a non-limiting example, the sensing system may include a component of the
cannula 100 configured to be recognized by a sensor in themanipulator arm 122 of the teleoperated surgical system. For example, the sensing component of thecannula 100 may be configured to be recognized by one or more of a proximity sensor, such as a photoelectric or electromagnetic sensor, a radio-frequency identification (RFID) sensor, a Hall-effect sensor, etc. of themanipulator arm 122. In some exemplary embodiments, the sensing component may be configured to change from a first state to a second state when thereturn electrode connector 112 is in a connected state with the return electrode connector receptacle comprising the returnelectrode connector interface 110 of thecannula 100. - In various exemplary embodiments, the first state and the second state may include, for example, a position, orientation, or other physical configuration of the sensing component, an electrical or magnetic state of the component, etc. For example, the first state and the second state may refer to physical positions and/or orientations of a magnet sensed by, e.g., a hall-effect sensor or other magnetic sensor, a shutter or other component sensed by a proximity sensor, etc. In some exemplary embodiments, the first state and the second state may refer to energized and non-energized states of a passive RFID tag, transmitting and non-transmitting states of a battery-assisted passive RFID tag, etc. In an exemplary embodiment, changing the state of the electrical connector sensing device includes changing radio-frequency electromagnetic waves (e.g., those being emitted by an RFID tag) being sensed by an electrical connector sensing device (e.g., an RFID sensor).
- In various exemplary embodiments, the return
electrode connector interface 110 is positioned laterally opposite to theattachment portion 118 of thecannula 100. With reference now toFIG. 3 ,cannula 200 has amechanical device 224 located between theattachment portion 118 of thecannula 200 and a return electrode connector interface 210 (also called “returnelectrode connector receptacle 210” in various embodiments). Themechanical device 224 is configured to alter in position and/or configuration when thereturn electrode connector 112 is engaged (e.g., mated) with the returnelectrode connector interface 210, such as being inserted within a receptacle of the returnelectrode connector interface 210. In some exemplary embodiments, the position and/or orientation of a component within or near theattachment portion 118 of the cannula may be altered by themechanical device 224 responsive to the act of engaging or disengaging thereturn electrode connector 112 with thereturn electrode connector 112. - For example, in the exemplary embodiment of
FIG. 3 , thecannula 200 includes apushrod 230 extending laterally across a portion of thecannula 200 from the returnelectrode connector interface 210 to theattachment portion 118. Thepushrod 230 may be in contact with aplunger 226 that is configured to extend at least partially into the returnelectrode connector receptacle 210 when the return electrode connector is not located within the returnelectrode connector receptacle 210. Insertion of thereturn electrode connector 112 within the returnelectrode connector receptacle 210 may cause thereturn electrode connector 112 to push against theplunger 226, forcing theplunger 226 to move downward (i.e., in a direction away from thereturn electrode connector 112 and generally parallel to a longitudinal axis of the cannula 200). Interaction between thepushrod 230 and theplunger 226 may convert the longitudinal motion of theplunger 226 to lateral movement in thepushrod 230, forcing thepushrod 230 to move indirection 232. For example, in the exemplary embodiment ofFIG. 3 , complementaryinclined planes 227 of thepushrod 230 and theplunger 226 convert the longitudinal motion of theplunger 226 to lateral movement of thepushrod 230. Thus, insertion of thereturn electrode connector 112 within the returnelectrode connector receptacle 210 causes thepushrod 230 to move from a position representing a disconnected state of thereturn electrode connector 112, to another position alongdirection 232 representing a connected state of thereturn electrode connector 112. Movement of thepushrod 230 in turn changes the position and/or orientation of a sensing device disposed within theattachment portion 118, as discussed in greater detail in connection with the exemplary embodiments ofFIGS. 3 and 4 below. - Other structures and configurations may be used to cause a change in state (e.g., position, orientation, etc.) of a component of the sensing system. For example, in other exemplary embodiments, the
pushrod 230 and theplunger 226 are a single rigid part configured to translate laterally as a unit in response to the return electrode connector being engaged with thereturn electrode interface 210. In some exemplary embodiments, thepushrod 230 may be replaced by a pivoting lever, or by any other mechanism configured to transfer movement between thereturn electrode connector 112 and an sensing device within theattachment portion 118. In some embodiments, thepushrod 230, or other mechanism of the sensing system, is biased, e.g., by a spring or other biasing element, to ensure that the sensing system returns to a position representing the disconnected state of thereturn electrode connector 112 when thereturn electrode connector 112 is removed from the returnelectrode connector receptacle 210. - Referring now to
FIG. 4 , another view of thecannula 200 ofFIG. 3 is shown. As seen inFIG. 4 , theattachment portion 118 of thesurgical cannula 200 may include an array of magnets 336 (e.g., a 2×2 array being depicted) (also called “array 336”). The array ofmagnets 336 and related portions of thesurgical cannula 200 may be substantially as described at least in Intl Pub. No. WO 2015/0142812, as incorporated by reference above. As described therein, the array ofmagnets 336 is configured to interact with sensors (e.g., Hall-effect sensors) disposed within a manipulator (e.g., manipulator 122 (FIG. 2 )) to identify various aspects or parameters of thecannula 100. For example, as discussed in WO 2015/0142812, the presence, absence, and/or polarity of each magnet of the array ofmagnets 336 can be associated with a particular aspect of thecannula 200 such as bowl diameter, length, shape of tube, number of uses, etc. Sensors within themanipulator 122 transmit information regarding the presence and/or polarity of each magnet of thearray 336 to the surgical system, where information regarding the particular combination of magnets and polarity is utilized by a processor or controller and memory to identify the configuration and/or state of thecannula 200. - In addition, in accordance with exemplary embodiments of the disclosure, the information provided to the surgical system by the array of
magnets 336 include the connected or disconnected state of thereturn electrode connector 112. For example, the combination of presence and/or polarity of the magnets of thearray 336 can be used to identify the particular design of the cannula 200 (e.g., bowl diameter, tube length, shape of tube, etc.) and the position and/or polarity of one or more magnets of thearray 336 also indicates whether thereturn electrode connector 112 is in a connected state with thecannula 200. - In an exemplary embodiment, a
magnet 338 of thearray 336 is mechanically coupled with the pushrod 230 (FIG. 3 ), such that movement of the pushrod 230 (e.g., as thereturn electrode connector 112 is inserted within or removed from the return electrode connector receptacle 210 (FIG. 3 )) causes a corresponding movement of themagnet 338. For example, themagnet 338 may be mechanically coupled directly with thepushrod 230 or through a linkage, a rack and pinion gear, etc., or any other suitable mechanical device. Movement of thepushrod 230 from a first position associated with the absence of thereturn electrode connector 112 from the returnelectrode connector receptacle 210 to a second position associated with the presence of thereturn electrode connector 112 within the return electrode connector receptacle comprising the returnelectrode connector interface 110 thereby moves themagnet 338 from a first position, configuration, and/or orientation to a second position, configuration, and/or orientation in a manner recognized by a sensor within the manipulator 122 (FIG. 2 ). - In an exemplary embodiment, movement of the
magnet 338 comprises translational movement from a first position within theattachment portion 118 to a second position within theattachment portion 118. In the first position, themagnet 338 is positioned proximate (e.g., within a sensing range of) a sensor, such as a Hall-effect sensor 123 (FIG. 2 ), within the receptacle 120 (FIG. 2 ) of the manipulator arm 122 (FIG. 2 ) when theattachment portion 118 is disposed within thereceptacle 120. In the second position, themagnet 338 is positioned out of the sensing range of thesensor 123 when theattachment portion 118 is disposed within thereceptacle 120. In other words, inserting thereturn electrode connector 112 within the return electrode connector receptacle 210 (FIG. 3 ) moves themagnet 338 from a first position in which themagnet 338 is within a sensing range of thesensor 123 in themanipulator 122, to a second position in which themagnet 336 is not within the sensing range of thesensor 123 in themanipulator 122. The presence or absence of themagnet 338 from the sensing range of thesensor 123 indicates to the surgical system the connected or disconnected status of thereturn electrode connector 112. - For example, with reference now to
FIG. 5 , a schematic view of an exemplary embodiment of a portion of a returnelectrode sensing device 501 is shown. In the embodiment ofFIG. 5 , apushrod 530 supports amagnet 538, which may, in some exemplary embodiments, form a portion of an array of magnets (e.g.,array 336 shown inFIG. 4 ). Thepushrod 530 is configured to move alongdirection 532 as a return electrode connector (e.g., thereturn electrode connector 111 inFIG. 2 ) is engaged with, or removed from, a return electrode connector interface (e.g., the returnelectrode connector interface 110 inFIG. 3 ). As shown inFIG. 5 , themagnet 538 may be disposed proximate (e.g., within a sensing range of) a sensor 523 (similar to, e.g.,sensor 123 discussed in connection withFIG. 2 ) when thepushrod 530 is in a position associated with the return electrode connector being engaged with the return electrode connector interface, as shown in solid lines inFIG. 5 . When the return electrode connector is disengaged from the return electrode connector interface, thepushrod 530 andmagnet 538 are positioned as shown in the dashed lines inFIG. 5 , and themagnet 538 is positioned outside of a sensing range of thesensor 523. Information regarding the position of themagnet 538 within, or outside of, the sensing range of thesensor 523 is processed by the surgical system to provide, e.g., a warning indication at a user interface (not shown) of the surgical system, a lockout condition, etc. - Additionally or alternatively, movement of the
magnet 338 may comprise movement that changes the pole of themagnet 338 presented to thesensor 123 of thereceptacle 120 of the manipulator 122 (FIG. 2 ). For example, in a first rotational position, one of the north pole and the south pole of the magnet is proximate thesensor 123 within thereceptacle 120 of themanipulator 122. Movement of thepushrod 230 causes themagnet 336 to rotate until the other of the north pole and south pole is proximate thesensor 123. Accordingly, the polarity of themagnet 338 presented to thesensor 123 may be used to determine the connected or disconnected status of thereturn electrode connector 112. - For example, with reference now to
FIG. 6 , a schematic view of another exemplary embodiment of a portion of a returnelectrode sensing system 601 is shown. In the embodiment ofFIG. 6 , apushrod 630 is connected to amagnet 638 by arack 625 andpinion 626 gear set. Themagnet 638 is rotatably attached (e.g., by a bearing, pin, etc.) to a cannula (e.g., at an attachment portion such asattachment portion 118 of cannula 100 (FIG. 2 )) and positioned proximate asensor 623 when theattachment portion 118 is engaged with the portion of the manipulator arm 122 (FIG. 2 ). Thepushrod 630 moves alongdirection 632 as a return electrode connector (e.g., thereturn electrode connector 111 inFIG. 2 ) is engaged with, or disengaged from, a return electrode connector interface (e.g., the returnelectrode connector interface 110 inFIG. 3 ). Linear movement of thepushrod 630 is converted to rotational movement of themagnet 638 through therack 625 andpinion 626 gear set. In other words, as thepushrod 630 moves alongdirection 632, thepinion gear 626 andmagnet 638 rotate together about arotational axis 627 of thepinion gear 626, as indicated bydirectional arrows 628. In the exemplary embodiment ofFIG. 6 , themagnet 638 has a north pole N and a south pole S. In the position illustrated inFIG. 6 , the south pole S of themagnet 638 is positioned proximate thesensor 623 when thereturn electrode connector 111 is engaged with the returnelectrode connector interface 110. When thereturn electrode connector 111 is disengaged from the returnelectrode connector interface 110, movement of thepushrod 630 and therack 625 causes thepinion 626 andmagnet 638 to rotate 180 degrees, positioning the north pole N of themagnet 638 proximate thesensor 623. Information regarding which pole of themagnet 638 is positioned proximate thesensor 623 may be processed by the surgical system, and the surgical system user interface may provide a warning or lockout condition based on the connected or disconnected status of thereturn electrode connector 111. - While the above description is made with reference to a
single magnet 338, any number or combinations of magnets of the array ofmagnets 336 may be configured to indicate the connected or disconnected state of thereturn electrode connector 112. - In another exemplary embodiment, the connected or disconnected state of a return electrode connector (e.g., return
electrode connector 112 shown inFIG. 3 ) with a cannula may be indicated by a proximity sensor. For example,FIG. 7 illustrates another exemplary embodiment of asurgical cannula 400 according to the disclosure. Thesurgical cannula 400 may have similar parts assurgical cannula 200 described in connection withFIGS. 3 through 4 . However, thesurgical cannula 400 includes ashutter 438 positioned in anopening 440 of an attachment portion 418 of thecannula 400. Theshutter 438 is configured to move between a first position, in which theshutter 438 is outside of sensing proximity of aproximity sensor 442 disposed in amanipulator arm 422, and a second position, in which theshutter 438 is within sensing proximity of theproximity sensor 442. Theproximity sensor 442 may comprise, for example, one or more of an optical proximity sensor, an electromagnetic proximity sensor, etc. - Movement of the
shutter 438 between the first position and the second position may be caused by mating of a return electrode connector (e.g., returnelectrode connector 112 shown inFIG. 3 ) with a return electrode connector interface. For example, in the exemplary embodiment ofFIG. 7 , thecannula 400 includes a returnelectrode connector interface 410 similar to theinterface 110 described above in connection withFIG. 2 . In an exemplary embodiment, movement of theshutter 438 may be effected by a mechanism similar to thepushrod 230 described in connection withFIG. 3 . Information regarding the connected or disconnected state of the return electrode connector may thus be provided in a manner otherwise similar to that discussed above in connection with the embodiment ofFIGS. 2 through 4 . - Although not illustrated in
FIG. 5 , thecannula 400 may also include an array of magnets similar to the array ofmagnets 336 described in connection withFIG. 4 . Such an array may be similarly configured to provide information regarding various parameters of thecannula 400 to a surgical system of which themanipulator arm 422 forms a part as described above in connection withFIG. 4 . However, those of ordinary skill in the art will appreciate that use of such a magnet array is optional. - Referring now to
FIG. 8 , another exemplary embodiment of acannula 500 and areturn electrode connector 512 according to the disclosure is shown. In this embodiment, thereturn electrode connector 512 includes a radio frequency identification (RFID) tag 544 configured and positioned to be recognized by an RFID sensor (not shown) positioned on a manipulator (e.g.,manipulator 122 shown inFIG. 2 ) when thereturn electrode connector 512 is within a specified range of the RFID sensor. For example, theRFID tag 544 of thereturn electrode connector 512 is within the specified range of the RFID sensor when thereturn electrode connector 512 is engaged with a returnelectrode connector interface 510, and theRFID tag 544 is outside of the specified range of the RFID sensor when thereturn electrode connector 512 is disconnected from mating engagement with the returnelectrode connector interface 510, such as being removed from mating engagement with the returnelectrode connector interface 510. Thus, when thereturn electrode connector 512 is not in an electrically connected state with thecannula 500, the RFID sensor within the manipulator may recognize the absence of theRFID tag 544 of thereturn electrode connector 512. As described above, the surgical system may provide a visual or audible indication, or a lockout condition, based on the disconnected state of thereturn electrode connector 512. - In the exemplary embodiments of
FIGS. 2, 3, 7, and 8 , theelectrical connector interface connector connector interface electrical connector -
FIG. 9 is a diagrammatic view of an exemplary teleoperated surgical system, with acannula 600 and aninstrument 646 shown in place on asurgical system 664 as well as in detail view. Thecannula 600 illustrated inFIG. 9 can be any one ofcannulas FIGS. 2 through 4, 7 and 8 .Return electrodes patient 652 positioned on an operating table 654, for example, beneath the patient's shoulders and buttocks, or at other locations that provide sufficient surface area contact between thereturn electrodes return electrode 648 also is electrically coupled to anelectrosurgical generator unit 656 through acable 658. Theelectrode 650 is configured to be electrically coupled to thecannula 600 through areturn electrode connector 612 of acable 660 configured to connect with a returnelectrode connector interface 610 of thecannula 600. Such connection forms an electrical contact between the patient 652 and thecannula 600. An electrically conductive path is thus created from thecannula 600 to thepatient 652 through theelectrode 650, and to theelectrosurgical generator unit 656 from theelectrode 648. - The
cannula 600 is configured to be disposed within an incision or orifice of thepatient 652, such as within a surgical port (not shown). Theinstrument 646 may include ashaft 662 extending through thecannula 600 with anend effector 663 configured to perform a function such as, for example, stapling, cutting, cauterizing, suturing, clamping, etc., or combinations thereof. Thecannula 600 andinstrument 646 may be connected to apatient side manipulator 664, such as those disclosed at least in Intl Pub. No. WO2015/0142812, U.S. Patent App. Pub. No. US 2013/0325033, U.S. Patent App. Pub. No. US 2013/0325031, and U.S. Pat. No. 8,852,208, each of which is incorporated by reference above. - The
cannula 600 and thepatient side manipulator 664 may include a return electrode connection sensing system according to any of the exemplary embodiments described above in connection withFIGS. 2 through 8 . For example, a return electrode connection sensing system may be configured to sense the engaged or disengaged state of thereturn electrode connector 612 with the returnelectrode connector interface 610 of thecannula 600, as described in the exemplary embodiments above. - The
patient side manipulator 664 may be configured to provide various safety notifications and/or interlocks based on the engaged or disengaged state of thereturn electrode connector 612 with the returnelectrode connector interface 610 of thecannula 600. For example, as described above, a user interface (not shown) associated with thepatient side manipulator 664 may be configured to provide a visual and/or audible notification to alert a user of the engaged or disengaged state of the returnelectrode connector interface 610 with thecannula 600. Additionally or alternatively, the user interface and/or the patient side manipulator may be configured to prevent application of electrical energy to theend effector 663 when thereturn electrode connector 612 is disengaged from the returnelectrode connector interface 610 of thecannula 600. - Further modifications and alternative embodiments will be apparent to those of ordinary skill in the art in view of the disclosure herein. For example, the devices, systems, and methods may include additional components or steps that were omitted from the diagrams and description for clarity of operation. Accordingly, this description is to be construed as illustrative only and is for the purpose of teaching those skilled in the art the general manner of carrying out the present disclosure. It is to be understood that the various embodiments shown and described herein are to be taken as exemplary. Elements and materials, and arrangements of those elements and materials, may be substituted for those illustrated and described herein, parts and processes may be reversed, and certain features of the present disclosure may be utilized independently, all as would be apparent to one skilled in the art after having the benefit of the description herein. Changes may be made in the elements described herein without departing from the scope of the present disclosure and following claims.
- It is to be understood that the particular examples and embodiments set forth herein are non-limiting, and modifications to structure, dimensions, materials, and methodologies may be made without departing from the scope of the present disclosure.
- Other embodiments in accordance with the present disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only, with being entitled to their full breadth of scope, including equivalents by the following claims.
Claims (21)
1-3. (canceled)
4. A surgical system, comprising:
a surgical manipulator;
a patient return electrode comprising an electrical connector and a sensible element attached to the electrical connector;
a cannula removably mountable to the surgical manipulator and configured to permit a medical instrument to be removably inserted into and advanced through the cannula in a mounted state of the cannula to the surgical manipulator, the cannula comprising an electrical connector interface configured to removably engage with the electrical connector of the patient return electrode;
a sensing device at the surgical manipulator and arranged to sense the sensible element of the patient return electrode in an engaged state of the electrical connector with the electrical connector interface of the cannula in a mounted state of the cannula; and
a controller operably coupled to the sensing device, the controller configured to:
receive information from the sensing device,
determine an engagement state of the electrical connector with the electrical connector interface based on the information received from the sensing device, and
control at least one operation of the surgical system based on determining the engagement state.
5. The surgical system of claim 4 , wherein the controller is configured to:
determine the electrical connector is in an engaged state with the electrical connector interface based on the sensing device sensing a presence of the sensible element; and
determine the electrical connector is in a disengaged state with the electrical connector interface based on the sensing device not sensing the presence of the sensible element.
6. The surgical system of claim 5 , wherein the sensing device is arranged such that:
the sensible element is located in a sensing range of the sensing device on condition of the electrical connector being in the engaged state with the electrical connector interface; and
the sensible element is located out of the sensing range of the sensing device on condition of the electrical connector being in the disengaged state with the electrical connector interface.
7. The surgical system of claim 4 , further comprising:
a user interface,
wherein controlling at least one operation of the surgical system comprises causing the user interface to display a visible notification in response to determining the electrical connector is in a disengaged state.
8. The surgical system of claim 4 , further comprising:
a user interface,
wherein controlling at least one operation of the surgical system based on the engagement information comprises causing the user interface to produce an audible notification in response to determining the electrical connector is in a disengaged state.
9. The surgical system of claim 4 , wherein controlling at least one operation of the surgical system based on the engagement information comprises disabling a function of the surgical system in response to determining the electrical connector is in a disengaged state.
10. The surgical system of claim 9 , wherein disabling a function of the surgical system comprises disabling supply of electrical power to a medical instrument mounted to the surgical manipulator.
11. The surgical system of claim 4 , wherein the sensible element comprises a radio frequency identification device (RFID) tag and the sensing device comprises an RFID sensor.
12. The surgical system of claim 5 , wherein the cannula comprises:
a bowl portion comprising an opening to permit removable insertion of a medical instrument into the bowl portion;
a tube portion extending distally from the bowl portion and configured to removably receive and permit advancement of a medical instrument inserted through the bowl portion; and
the electrical connector interface at the bowl portion.
13. The surgical system of claim 12 , wherein:
the manipulator arm comprises a cannula mount; and
the cannula further comprises an attachment portion protruding laterally from a sidewall of the bowl portion and configured to be removably coupled with the cannula mount to removably mount the cannula to the manipulator arm.
14. A surgical system, comprising:
a manipulator configured to removably mount a cannula, the cannula configured to permit removeable insertion of a medical instrument;
a sensing device at the manipulator, the sensing device configured to sense a sensible element of a patient return electrode; and
a controller operably coupled to the sensing device, the controller configured to:
receive information from the sensing device,
determine an engagement state of the patient return electrode with the cannula based on the information received from the sensing device, and
control at least one operation of the surgical system based on determining the engagement state.
15. The surgical system of claim 14 , wherein the controller is configured to:
determine the patient return electrode is in an engaged state with the cannula based on the sensing device sensing a presence of the sensible element; and
determine the patient return electrode is in a disengaged state with the cannula based on the sensing device not sensing the presence of the sensible element.
16. The surgical system of claim 15 , wherein the sensing device is arranged such that:
the sensible element is located in a sensing range of the sensing device on condition of the patient return electrode being in the engaged state with the cannula in the mounted state of the cannula; and
the sensible element is located out of the sensing range of the sensing device on condition of the patient return electrode being in the disengaged state with the cannula in the mounted state of the cannula.
17. The surgical system of claim 14 , further comprising:
a user interface,
wherein controlling at least one operation of the surgical system comprises causing the user interface to display a visible notification, produce an audible notification, or both, in response to determining the patient return electrode is in a disengaged state with the cannula.
18. The surgical system of claim 14 , wherein controlling at least one operation of the surgical system comprises disabling a function of the surgical system in response to determining the patient return electrode is in a disengaged state.
19. The surgical system of claim 18 , wherein disabling a function of the surgical system comprises disabling supply of electrical power to a medical instrument mounted to the manipulator.
20. The surgical system of claim 14 , wherein the sensible element comprises a radio frequency identification device (RFID) tag and the sensing device comprises an RFID sensor.
21. A method of operating a surgical system, comprising:
in a mounted state of a cannula to a surgical manipulator:
receiving, from a sensing device at the surgical manipulator, information indicative of a sensed presence or absence of a sensible element of a patient return electrode;
determining, based on the information, a state of engagement of the patient return electrode with the cannula; and
controlling at least one operation of the surgical system based on the determined state of engagement,
wherein the cannula is configured to permit removable insertion of a medical instrument.
22. The method of claim 21 ,
wherein sensing the state of engagement comprises sensing the electrical connector is in an engaged state with the electrical connector interface in response to sensing the presence of the sensible element by the sensing device; and
23. The method of claim 21 ,
wherein sensing the state of engagement comprises sensing the electrical connector is in a disengaged state with the electrical connector interface in response to sensing the absence of the sensible element by the sensing device.
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US15/624,148 US11026757B2 (en) | 2016-07-20 | 2017-06-15 | Surgical cannulas, and related systems and methods |
US17/325,825 US20210338353A1 (en) | 2016-07-20 | 2021-05-20 | Surgical cannulas, and related systems and methods |
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US12239777B2 (en) | 2018-07-24 | 2025-03-04 | Penumbra, Inc. | Thrombectomy systems and methods for controlled clot aspiration |
CN112767649B (en) * | 2020-12-22 | 2021-12-21 | 吉林大学 | A pipeline slip reminder device based on the detection of the pressure in the patient's body |
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